Microbiological Results Research Articles

Agreement between Phenotypically Detected Linezolid Resistance and Mutations in rrl and rplC Genes of Mycobacterium tuberculosis Isolates Using Nanopore Sequencing.

Phenotypic drug susceptibility testing (DST) is considered the gold standard for detecting linezolid (LZD) resistance in Mycobacterium tuberculosis (MTB), but it is time-consuming. Nanopore sequencing offers a potentially faster alternative approach. This study evaluated the agreement between phenotypically detected LZD resistance and mutations in the rrl and rplC genes of MTB isolates using nanopore sequencing. Consecutive drug-resistant MTB isolates from pulmonary samples collected in 2021 underwent liquid culture (LC) DST for LZD. All resistant isolates and an equal number of susceptible isolates were subjected to targeted sequencing of the rrl and rplC genes using nanopore technology. Sequencing identified a C154R mutation in the rplC gene in only one LZD-resistant isolate. No mutations were detected in the rrl gene. The agreement between sequencing and LC-DST for detecting LZD resistance was poor (Cohen's kappa: 0.03571, 95% confidence interval [CI]: -0.034-0.105). Additionally, no significant association was found between LZD resistance and clinical or microbiological outcomes at 6-month follow-up. This study revealed a considerable discrepancy between phenotypic and genotypic detection of LZD resistance in MTB. Further research is needed to better understand the genetic mechanisms underlying LZD resistance and to develop reliable molecular diagnostics for rapid resistance detection.

Timesavers: Clinical Decision Support and Automation of MRSA and VRE Deisolation

Background: Most healthcare facilities in the US apply contact precautions (CP) for patients with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) infection and/or colonization. Most individuals with MRSA or VRE colonization will clear over time; however, frontline clinicians rarely evaluate for discontinuation of CP, resulting in increased burden on infection preventionists (IPs). Automation of time- and test-based evaluation using clinical decision support systems (CDSS) embedded in electronic health records (EHR) may increase evaluation and discontinuation of CP when appropriate, while preserving IP resources. Methods: This quality improvement initiative was implemented at Mass General Brigham (MGB), an integrated healthcare system, where patients with MRSA or VRE infection/colonization are identified in the EHR with a corresponding “infection status” and CP applied. Following MGB policy (Figure 1), CDSS features included: 1) automated time-based resolution from 2/15/2023-11/13/2023 and 2) automated ordering of screening assays for patients eligible for test-based evaluation from 6/20/2023-11/14/2023 (Figure 2). Counts of CP discontinuation and automated ordering were performed. IPs at one MGB facility performing manual review of patients self-recorded the time spent evaluating for CP discontinuation. Using these time reports, the average time to complete these tasks and the projected time savings were calculated over the implementation period. Results: Four IPs recorded the time to review patients for CP discontinuation, including reviewing recent antimicrobial administration, microbiology results, ordering screening test(s), and contacting the primary team. Twenty-five patient encounters were timed with a mean of 4.7 minutes documented per encounter. Over a 9-month period after initiation of the automated time-based resolution, the monthly mean number of patients with CP for MRSA and VRE which were automatically discontinued was 247 and 100, respectively. Projected IP time savings over the same 9-month period for MRSA and VRE were 174.1 and 70.5 hours, respectively. Over a 5-month period after initiation of automated ordering of MRSA polymerase chain reaction (PCR)/culture, as well as VRE culture for test-based evaluation, the monthly mean number of MRSA culture, MRSA PCR, and VRE culture automatically ordered for patients on CP for MRSA and VRE were 176, 24, and 145, respectively. Projected IP time savings over the same 5-month period for MRSA and VRE were 78.3 and 56.8 hours, respectively.Conclusion: Healthcare systems that enhance their EHR with CDSS to automate CP evaluations may improve frontline clinician workflow, patient flow and bed capacity, while optimizing use of IP resources.

Infections in residents of long- term care facilities in southern Poland, 12-month surveillance preliminary results

Long-Term Care Facility (LTCF) residents are particularly vulnerable to infections due to factors such as advanced age, co-morbidities, and regular medication use. Data from American and European sources indicate an anticipated occurrence rate of 2 to 11 infections per 1000 patient-days (pds) in LTCFs. The incidence rate of Clostridioides difficile infections (CDI) is reported at 0.52 per 10,000 resident days. The research objectives aimed to assess infection epidemiology in Polish LTCFs. An observational prospective study was conducted on residents from five LTCFs (2 residential homes and 3 nursing homes) in southern Poland between September 2022 and September 2023, utilizing the definition from the pan-European HALT study. The study received approval from the Bioethics Committee of the JU (1072.6120.73.2022) and was funded by the Polish NCN grant No.2021/41/B/NZ6/00749. CDI was defined by positive toxins A and B enzyme immunoassays (EIA) and positive glutamate dehydrogenase (DHA) EIA. Results from the study, involving 250 residents, revealed 157 cases of Healthcare-Associated Infections (HAIs) excluding gastrointestinal and CDI, with an incidence rate of 1.97/1000 pds. Lower respiratory tract infections dominated with 77 cases, including 36 pneumonia cases (47%). Additionally, 25 cases of gastrointestinal infections were reported, including only 7 CDI cases, resulting in an incidence rate of 0.88 CDI per 10,000 pds. Norovirus was detected in only one case, while the microbiological results were negative in the remaining cases. The incidence rate among Polish LTCF residents was lower than expected, contrasting with the CDI incidence that aligned with other research findings. Notably, the etiology of diarrhea remained undetermined in 68% of cases.

Use of encapsulated açaí oil with antioxidant potential in fresh sausage

The effect of açaí oil capsules on fresh pork sausages was evaluated. Four treatments were developed: C: without addition of açaí oil capsules, T1: with addition of 1.5 g/kg of açaí oil capsules, T2: with addition of 2.5 g/kg of açaí oil capsules, T3: with addition of 3.5 g/kg of açaí oil capsules. The lipid content increased with the addition of açaí oil capsules, and the microbiological results were in accordance with legislation. There was an improvement in the fatty acid profile with the incorporation of açaí oil capsules, with a higher content of unsaturated fatty acids. Açaí oil capsules reduced oxidation, especially protein oxidation, and did not interfere with sensory characteristics. The color and texture parameters were affected by the incorporation of the capsules and storage time. Therefore, the incorporation of açaí oil capsules proved to be effective in improving the oxidation of fresh sausages, as well as improving the fatty acid profile, making the product healthier.

The Impact of Laboratory Automation on the Time to Urine Microbiological Results: A Five-Year Retrospective Study.

Total laboratory automation (TLA) is a valuable component of microbiology laboratories and a growing number of publications suggest the potential impact of automation in terms of analysis standardization, streaking quality, and the turnaround time (TAT). The aim of this project was to perform a detailed investigation of the impact of TLA on the workflow of commonly treated specimens such as urine. This is a retrospective observational study comparing two time periods (pre TLA versus post TLA) for urine specimen culture processing. A total of 35,864 urine specimens were plated during the pre-TLA period and 47,283 were plated during the post-TLA period. The median time from streaking to identification decreased from 22.3 h pre TLA to 21.4 h post TLA (p < 0.001), and the median time from streaking to final validation of the report decreased from 24.3 h pre TLA to 23 h post TLA (p < 0.001). Further analysis revealed that the observed differences in TAT were mainly driven by the contaminated and positive samples. Our findings demonstrate that TLA has the potential to decrease turnaround times of samples in a laboratory. Nevertheless, changes in laboratory workflow (such as extended opening hours for plate reading and antibiotic susceptibility testing or decreased incubation times) might further maximize the efficiency of TLA and optimize TATs.

Improving the storage quality of Harbin red sausages by quaternized chitosan/sodium alginate coating curcumin nano-emulsion

In this study, the effect of sodium alginate and quaternized chitosan bis-polysaccharide-based shell transport curcumin nano-emulsions (Cur@QCS/SA) on the microbiological, physicochemical properties, quality characteristics of Harbin red sausage during storage is investigated. According to the microbiological results, the shelf life of Harbin red sausage is extended from 3 d to 6 d by adding 0.15% Cur@QCS/SA, and Bacillus is the most predominant bacterial before 6 d. Additionally, the physicochemical properties change significantly, the pH, weight loss (WL), water holding capacity (WHC), water activity (aw), L*, and a* of red sausage decrease gradually with the extension of storage time, as well as b*, lipid oxidation, proteolysis increase significantly (P < 0.05). Secondly, it is found that 0.15% treatment group can better maintain the quality characteristics of Harbin red sausage according to texture profile analysis (TPA), electronic nose (E-nose), and electronic tongue (E-tongue) (P < 0.05). This study provides a new way for nano-emulsions in food applications and a new option for the preservation of Harbin red sausage as well as other low-temperature meat products.

Comprehensive analysis of clinical outcomes, infectious complications and microbiological data in newly diagnosed multiple myeloma patients: a retrospective observational study of 92 subjects

Patients with multiple myeloma (MM) have an increased risk of sepsis due to underlying disease- and treatment-related immunosuppression. However, data on sepsis incidence, causative pathogens, and impact on outcomes in newly diagnosed MM (NDMM) are limited. We conducted a retrospective observational study of 92 NDMM patients who developed sepsis between 2022 and 2023 at a tertiary care center in Italy. Patient characteristics, sepsis criteria [Quick Sequential Organ Failure Assessment, Systemic Inflammatory Response Syndrome (SIRS)], microbiology results, and associations with progression-free survival (PFS) were analyzed. In this cohort of 92 critically-ill patients, pathogenic organisms were identified via microbiological culture in 74 cases. However, among the remaining 18 culture-negative patients, 9 exhibited a SIRS score of 2 and another 9 had a SIRS score of 4, suggestive of a clinical presentation consistent with sepsis despite negative cultures. Common comorbidities included renal failure (60%), anemia (71%), and bone disease (83%). Gram-negative (28%) and Gram-positive (23%) bacteria were frequent causative organisms, along with fungi (20%). Cox Univariate analyses for PFS showed statically significant HR in patients with albumin ≥ 3.5 vs < 3.5 (HR = 5.04, p < 0.001), Karnofsky performance status ≥ 80 vs < 80 (HR = 2.01, p = 0.002), and early-stage vs late-stage disease by International Staging System (HR = 4.76 and HR = 12.52, both p < 0.001) and Revised International Staging System (R-ISS III vs R-ISS I, HR = 7.38, p < 0.001). Sepsis is common in NDMM and associated with poor outcomes. Risk stratification incorporating sepsis severity, comorbidities, and disease stage may help guide preventive strategies and optimize MM management.

Ceftazidime-Avibactam Use in a Case Series of Difficult-to-Treat or Recurrent Infections in Pediatric Patients with Complex Chronic Conditions: Effectiveness and Absence of Resistance Development.

The prevalence of multidrug-resistant Gram-negative infections, particularly carbapenem-resistant strains, has become a significant global health concern. Ceftazidime-avibactam (CZA) has emerged as a promising treatment option. However, data on its efficacy and safety in children are scarce, necessitating further investigation. We conducted a descriptive case series at a tertiary hospital in Spain from February 2019 to January 2022. Pediatric patients (<16 years) treated with CZA for confirmed or suspected multidrug-resistant Gram-negative infections were included. The clinical and microbiological characteristics, treatment approaches, and outcomes were examined. Eighteen children received CZA treatment. All had complex chronic conditions, with the most frequent underlying main diseases being liver transplantation (n = 8) and biliary atresia (n = 4). The predominant type of infection for which they received CZA was intra-abdominal infection caused or suspected to be caused by OXA-48-producing Klebsiella pneumoniae. CZA was generally well tolerated. Within the first month of starting CZA therapy, two patients died, with one case directly linked to the infection's fatal outcome. Some patients needed repeated courses of therapy due to recurrent infections, yet no resistance development was noted. In summary, the use of CZA showed effectiveness and safety, while the lack of resistance development highlights CZA's potential as a primary treatment option against OXA-48-producing infections.

Clinical sub-phenotypes of Staphylococcus aureus bacteraemia.

Staphylococcus aureus bacteraemia (SAB) is a clinically heterogeneous disease. The ability to identify sub-groups of patients with shared traits (sub-phenotypes) is an unmet need that could allow patient stratification for clinical management and research. We aimed to test the hypothesis that clinically-relevant sub-phenotypes can be reproducibly identified amongst patients with SAB. We studied three cohorts of hospitalised adults with monomicrobial SAB: a UK retrospective observational study (Edinburgh cohort, n=458), the UK ARREST randomised trial (n=758), and the Spanish SAFO randomised trial (n=214). Latent class analysis was used to identify sub-phenotypes using routinely-collected clinical data, without considering outcomes. Mortality and microbiologic outcomes were then compared between sub-phenotypes. Included patients had predominantly methicillin-susceptible SAB (1366/1430,95.5%). We identified five distinct, reproducible clinical sub-phenotypes: (A) SAB associated with older age and comorbidity, (B) nosocomial intravenous catheter-associated SAB in younger people without comorbidity, (C) community-acquired metastatic SAB, (D) SAB associated with chronic kidney disease, and (E) SAB associated with injection drug use. Survival and microbiologic outcomes differed between the sub-phenotypes. 84-day mortality was highest in sub-phenotype A, and lowest in B and E. Microbiologic outcomes were worse in sub-phenotype C. In a secondary analysis of the ARREST trial, adjunctive rifampicin was associated with increased 84-day mortality in sub-phenotype B and improved microbiologic outcomes in sub-phenotype C. We have identified reproducible and clinically-relevant sub-phenotypes within SAB, and provide proof-of-principle of differential treatment effects. Through clinical trial enrichment and patient stratification, these sub-phenotypes could contribute to a personalised medicine approach to SAB.

Evaluation of the Nutritional Quality and Shelf Life of Fermented Processed Sheep Salami Inoculated with Lactobacillus casei and Lactobacillus paracasei

The aim of this study was to produce two fermented processed foods made from sheep meat, one of them inoculated with the probiotic Lactobacillus casei and the other with Lactobacillus paracasei, evaluating their microbial growth, viability, and the efficiency of these microorganisms as bioconservants. To that effect, physicochemical, physical, and microbiological analyses were carried out, as well as a count of lactic acid bacteria (LAB). The results regarding the physicochemical and physical characteristics were in accordance with Brazilian legislation, except for the humidity and carbohydrate analysis and water activity, the values of which were not in accordance with the legislation. However, the microbiological results regarding the pathogenic microorganisms’ growth were within the standard established in the legislation until the end of the time of analysis. Regarding the presence of probiotics, both fermented processed foods had values higher than 107 CFU/g relative to LAB count until the limit of 84 days. From these results, it can be concluded that the probiotics are viable, showing bioconservative activity and proper consumption conditions, since they are in conformity with the legislation.

Analisa Manajemen Proyek Pada Pemanfaatan Limbah Stik Es Krim Menjadi Lampu Tidur

This waste used from ice cream sticks will be transformed into a lantern with contemporary aesthetics that can function both as equipment and ornament. The issue of needs and desires, or fulfilling needs, always confronts humanity. Needs are requirements for human survival; among them are economic needs, which are basic needs for society and are therefore met through various work patterns, procedures and strategies. Continuous efforts to meet needs require rational behavior from individuals, which requires action to prevent inefficiency and waste. Conclusion Specific criteria, such as the amount of active components, safety standards, and microbiological test results, are necessary to evaluate tissue quality. It is important to carry out thorough testing at every stage of the production process to guarantee that recyclable containers are of the highest quality.

Parvimonas micra-related spondylodiscitis: A case report and systematic literature review

The purpose of this study is to report a case of Parvimonas micra-related spondylodiscitis (PMSD) and conduct a systematic review of the literature to identify clinical, microbiologic, and radiographic assessment and treatment outcomes. This research was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic review of the Literature indexed in PubMed, MEDLINE, and Scopus databases was performed from 1970 to December 2023 using search terms “vertebral,” “spinal,” “infection,” “spondylodiscitis,” “discitis,” “osteomyelitis,” “Parvimonas,” and “micra.” The systematic review identified 34 cases of PMSD in addition to the reported case after the screening of 472 titles and abstracts. Patients reported several clinical presentations, with back pain being the most common symptom. Treatment strategies included antibiotic therapy alone or in combination with surgery, resulting in favorable outcomes for the majority of patients. However, challenges such as delayed diagnosis and lack of standardized treatment protocols were observed. The P. micra is an emerging pathogen in spinal infections, particularly in patients with predisposing factors. This study highlights the need for heightened awareness among healthcare providers regarding the potential role of anaerobic bacteria in spondylodiscitis. Standardized diagnostic and treatment protocols are warranted to improve outcomes for patients with PMSD.

Development of iron-fortified chocolate milk for preschool children based on sensory acceptability

Milk is among the most important foods used in the daily diet of children and maybe a suitable option for fortification with minerals such as iron that help reduce iron deficiencies and anemia in children. The objective of the present investigation is to fortify with heme iron from pig blood powder, and pasteurized milk with chocolate flavor and to study its sensory acceptability in a group of children aged 3-5 years. The study variables in milk preparation were iron concentration and sugar content. The compound factorial design and the response optimization allowed for finding an optimal range corresponding to 25% of the recommended dose of iron for children. The formula with the highest acceptability (4.72/5) presented a concentration of 13.65 mg Fe L-1 , 693 mg L-1 vitamin C and 60 g L-1 sugar. According to the physicochemical and microbiological results, the fortified flavored milk complied with regulations and had an approximate shelf life of 5 days. These results showed an alternative for heme iron fortification of chocolate milk, whose content could contribute to the daily requirement of this mineral in children aged 3- 5 years (11 mg of iron per day for a consumption of 250 mL).

Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: Retrospective Clinical Analysis from a Tertiary Transplant Center.

Aspergillosis is the most common invasive fungal infection among lung transplant recipients (LTRs). Although its incidence is lower than that of bacterial or viral infections, it poses a similar or even higher mortality rate due to challenges in early diagnosis, limited treatment options, and various complications. Therefore, we aimed to evaluate the pulmonary aspergillosis cases in our tertiary lung transplant center. A retrospective analysis of 146 LTRs was performed. The demographic data, microbiological and histopathological test results, and radiological findings used for Aspergillus identification were recorded. Aspergillus spp. was detected in 13 of 146 LTRs (9%), mean age 42.5 ± 14.06 years, an average of 18.9 months after lung transplantation. 3 cases (23%) had Aspergillus growth in tissue culture, and 2 (15.4%) showed fungal elements with septal hyaline fibrils in tissue pathology. Aspergillus spp Polymerase chain reaction (PCR) was positive in bronchoalveolar lavage of 8 (61.5%) cases. In addition, 4 (30.7%) cases had relevant tomography findings. The most common pathogens were A. Terreus (21%), A. Fumigatus (14%), and A. Flavus (14%). The mortality rate was 15%. LTRs are at high risk of Aspergillus spp infections. Early diagnosis with microbiological, histopathological, and radiological tests, in addition to well-established prevention strategies, prophylaxis, and treatment will provide a better survival rate for patients.

Gallium-doped zirconia coatings modulate microbiological outcomes in dental implant surfaces.

Despite the significant recent advances in manufacturing materials supporting advanced dental therapies, peri-implantitis still represents a severe complication in dental implantology. Herein, a sol-gel process is proposed to easily deposit antibacterial zirconia coatings onto bulk zirconia, material, which is becoming very popular for the manufacturing of abutments. The coatings' physicochemical properties were analyzed through x-ray diffraction and scanning electron microscopy-energy-dispersive x-ray spectroscopy investigations, while their stability and wettability were assessed by microscratch testing and static contact angle measurements. Uniform gallium-doped tetragonal zirconia coatings were obtained, featuring optimal mechanical stability and a hydrophilic behavior. The biological investigations pointed out that gallium-doped zirconia coatings: (i) displayed full cytocompatibility toward human gingival fibroblasts; (ii) exhibited significant antimicrobial activity against the Aggregatibacter actinomycetemcomitans pathogen; (iii) were able to preserve the commensal Streptococcus salivarius. Furthermore, the proteomic analyses revealed that the presence of Ga did not impair the normal oral microbiota. Still, interestingly, it decreased by 17% the presence of Fusobacterium nucleatum, a gram-negative, strictly anaerobic bacteria that is naturally present in the gastrointestinal tract. Therefore, this work can provide a valuable starting point for the development of coatings aimed at easily improving zirconia dental implants' performance.

Pediatric Endophthalmitis Over the Last Five Decades: A Case Report and Systematic Review.

Pediatric infectious endophthalmitis is a rare, severe ocular infection that can have devastating consequences. It may be exogenous or endogenous, with exogenous endophthalmitis being more common. Current data on the etiology, microbiology, antibiotic treatments and outcomes in pediatric cases is limited. To summarize the etiology, microbiology, visual outcomes and management of pediatric endophthalmitis. A literature review was conducted on cases of pediatric endophthalmitis published from 1980 to 2022, identified through searches of PubMed, Medline, Web of Science and Google Scholar databases. A total of 796 patients were included. Ocular trauma was the most common cause with 623 patients (78.3%), followed by posteye surgery with 100 patients (12.6%) and endogenous endophthalmitis with 67 patients (70 eyes) (8.4%). Among culture-positive cases, gram-positive microorganisms predominated. Treatment involved pars plana vitrectomy in 608 patients (76%) and intraocular antibiotics in 590 patients (74%). Favorable visual acuity (≥20/200) was achieved in 30.5% of patients, 20% had no light perception and 12.5% developed poor anatomical outcomes with phthisis bulbi. Our review provides insights into the etiology, epidemiology, microbiology, treatment and visual outcomes of pediatric endophthalmitis based on available literature worldwide.

Synergistic Combination of Aztreonam and Ceftazidime–Avibactam—A Promising Defense Strategy against OXA-48 + NDM Klebsiella pneumoniae in Romania

With the increasing burden of carbapenem-resistant Klebsiella pneumoniae (CR-Kp), including high rates of healthcare-associated infections, treatment failure, and mortality, a good therapeutic strategy for attacking this multi-resistant pathogen is one of the main goals in current medical practice and necessitates the use of novel antibiotics or new drug combinations. Objectives: We reviewed the clinical and microbiological outcomes of seven patients treated at the “Agrippa Ionescu” Clinical Emergency Hospital between October 2023 and January 2024, aiming to demonstrate the synergistic activity of the ceftazidime–avibactam (C/A) plus aztreonam (ATM) combination against the co-producers of blaNDM + blaOXA-48-like CR-Kp. Material and Methods: Seven CR-Kp with blaNDM and blaOXA-48 as resistance mechanisms were tested. Seven patients treated with C/A + ATM were included. The synergistic activity of C/A + ATM was proven through double-disk diffusion in all seven isolates. Resistance mechanisms like KPC, VIM, OXA-48, NDM, IMP, and CTX-M were assessed through immunochromatography. Results: With a mean of nine days of treatment with the synergistic combination C/A + ATM, all patients achieved clinical recovery, and five achieved microbiological recovery. Conclusions: With the emerging co-occurrence of blaOXA-48 and blaNDM among Kp in Romania, the combination of C/A and ATM could be a promising therapeutic option.

Microbial fuel cells with polychlorinated biphenyls contaminated soil as electrolyte: energy performance and decontamination potential in presence of compost

The electrical performance of Terrestrial Microbial Fuel Cells (TMFCs) with soil as the electrolyte was tested with two concentrations (150 or 250 ng/g soil) of PCBs (Polychlorinated biphenlys) and compost (3 % w/w) in an experiment lasting 60–80 days. Energy output levels were recorded daily by varying the external resistance for detecting the best operating conditions. PCB concentrations and microbiological analyses (total microbial abundance and activity) were performed at the start and end of the experiment. The highest power generation (207 ± 80 mW/m2 at 112.5 Ω) was recorded in the presence of compost with the lowest PCB concentration, when compared to TMFCs without compost (1.5 ± 0.2 mW/m2 at 300.8 Ω). The results demonstrated that the power generation was correlated with a lower internal resistance and a higher microbial activity. Moreover, chemical results indicated a possible threshold of PCB concentration for the concurrently electricity production and PCB degradation. In fact, PCB removal was obtained only in the cells with high PCB concentration, achieving a reduction of 21 % and 16 % with and without compost, respectively. The microbiological results showed that an additional organic carbon source (methanol or compost) promoted microbial activity and abundance. A positive correlation was found between microbial activity and TMFC electrical output only in the case of PCB low concentration, in the presence of compost. No previous studies addressed the performance of TMFCs with different levels of PCBs in terms of soil decontamination and electricity production. Although a longer experiment is needed, considering PCB persistence in soils, this experiment provided useful information and a new insight on the TMFC effectiveness for soil decontamination and electricity production. The results presented here support considerations about soil resilience through microbial communities and orient further research on contaminant degradation by TMFCs.

Providing microbiology education to rural nurses: A case study

Objective: This case study assesses a microbiology and infection control education workshop delivered to rural nurses. The study assesses workshop value through changes in respondents’ self-assessed confidence using measures of microbiology knowledge, teaching, and best practice. Respondents also identified the aspects of the education perceived as most useful to their practice and barriers to implementing microbiology education in practice. Study design and methods: Pre- and post-workshop surveys were administered to the participants. The surveys used a 7-point ordinal scale to measure respondents’ confidence in explaining key concepts and their perception of the influence of such education opportunities on positive patient outcomes. Change in ratings was analysed using Wilcoxon signed-ranks tests; whilst the open-ended survey responses were analysed using a manifest content analysis. Results: All thirteen nurses who participated in the education workshop responded to both surveys. The results demonstrated a significant increase post-workshop in confidence measures and belief that microbiology and infection control education influence positive patient outcomes. The perceived barriers to implementation of microbiology education in practice included poor organisational culture, lack of access to training, and lack of resources. Discussion: This case study describes a method of providing microbiology education to rural nurses and highlights the benefit of this access, particularly in the mode of face-to-face learning. A suggestion for future iterations of the program is to include content that would support nurses’ implementation of theory to practice. Conclusion: A face-to-face microbiology and infection prevention workshop, which enables participants to discuss content and undertake a tour of the pathology laboratory for practical insights, enhances nurses’ self-rated confidence on this topic. Implications for research, policy, and practice: This study demonstrates the significance of microbiology education for rural nurses and describes how this can be undertaken in practice, with insight provided on the most valued aspects. It also shows the importance of supporting in-person education. Future research could address the medium to long terms effects of this education for nurses and their practice. What is already known about the topic? Access to continuing professional development is difficult for rural nurses, particularly in comparison to their urban counterparts. Nurses hold a vital role in infection prevention and infection control. Increased knowledge leads to positive patient care and positive patient outcomes. What this paper adds It demonstrates that providing microbiology education to rural nurses increases their confidence in the topical area. It provides an example program for delivering microbiology education to rural nurses. It highlights the benefits of the face-to-face aspect of education and practical component of the laboratory tour.

Clinical characteristics and outcomes of aortic prosthetic valve endocarditis: comparison between transcatheter and surgical bioprostheses

Abstract Purpose Most data regarding infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) comes from TAVI registries, rather than IE dedicated cohorts. The objective of our study was to compare the clinical and microbiological profile, imaging features and outcomes of patients with IE after SAVR with a biological prosthetic valve (IE-SAVR) and IE after TAVI (IE-TAVI) from 6 centres with an Endocarditis Team (ET) and broad experience in IE. Methods Retrospective analysis of prospectively collected data. From the time of first TAVI implantation in each centre to March 2021, all consecutive patients admitted for IE-SAVR or IE-TAVI were prospectively enrolled. Follow-up was monitored during admission and at 12 months after discharge. Results 169 patients with IE-SAVR and 41 with IE-TAVI were analysed. Early episodes were more frequent among IE-TAVI. Clinical course during hospitalization was similar in both groups, except for a higher incidence of atrioventricular block in IE-SAVR. The most frequently causative microorganisms were S. epidermidis, Enterococcus spp. and S. aureus in both groups. Periannular complications were more frequent in IE-SAVR. Cardiac surgery was performed in 53.6% of IE-SAVR and 7.3% of IE-TAVI (p=0.001), despite up to 54.8% of IE-TAVI patients had an indication. No differences were observed about death during hospitalization (32.7% vs 35.0%), and at 1-year follow-up (41.8% vs 37.5%), regardless of whether the patient underwent surgery or not. Conclusion Patients with IE-TAVI had a higher incidence of early prosthetic valve IE. Compared to IE-SAVR, IE-TAVI patients underwent cardiac surgery much less frequently, despite having surgical indications. However, in-hospital and 1-year mortality rate was similar between both groups.